Propofol mechanism — FRCA Primary MCQ
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Correct answer: B — It enhances GABA-A receptor chloride channel activity
Propofol causes hypnosis principally by potentiating GABA-A mediated chloride conductance. It is hydrolysed by nonspecific esterases is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. It chelates unfractionated heparin is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. It activates central alpha-2 receptors is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. It inhibits prostaglandin synthesis is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. In Primary FRCA pharmacology, link the clinical effect to the receptor, distribution or elimination mechanism rather than memorising isolated facts.
Reference: Peck, Hill & Williams Pharmacology for Anaesthesia and Intensive Care; BNF; Primary FRCA textbooks